What is the Difference Between a Family Doctor and Nurse Practitioner

If you’re like most Canadians, you may not be quite sure what the difference between a nurse practitioner (NP) and a family doctor is. After all, hearing that someone with “nurse” in their title is going to be your primary care provider may be confusing. If that’s the case, you’ve come to the right place. We’re breaking down the differences between NPs and family doctors, otherwise known as family physicians in Canada, so you can feel confident about choosing the health professional that’s right for you.

What’s the difference between a family doctor and a nurse practitioner?

Both family physicians and NPs are highly-trained professionals. But, because the education each gets is different, they approach patient care a little differently. There a few key differences between the two:

• Education and training
• Treating medically complex patients
• Prescribing controlled substances
• Option to train in obstetrics

NPs must practice full-time as a registered nurse for at least two years before completing a two-year Master of Nursing (MN) program. This training encourages NPs to look at their patients holistically, which means they aim to protect, promote, and optimize their overall health.

Family physicians in Canada complete three or four years of medical school, followed by a two to three-year family medicine residency, with the third year being optional for additional specialization. This extensive technical education teaches physicians to look at patient care through a comprehensive medical lens. As a result, they focus more on diagnostics and specialized treatments.

Ultimately, both NPs and family physicians treat and support a variety of patients — including those with chronic health issues. However, because of their more robust education and training, family physicians may be better suited to treating the competing health conditions of medically complex patients.

What can family doctors do that nurse practitioners can’t?

Whether you see a family physician or an NP, you’re going to get great primary care. However, there are some differences in how they operate. One of the major differences when it comes to nurse practitioners vs. family physicians surrounds what they’re able to prescribe.

Controlled substances like opioids, benzodiazepines, and sedatives are an important part of the medical toolkit. They’re much-needed medications for patients experiencing conditions such as anxiety, pain, or sleep disorders. Unfortunately, these medications also have the potential to be abused, which is why they’re controlled substances.

Family physicians receive extensive training on these medications during medical school and can prescribe them when they’re necessary and in the best interest of the patient.

NPs, in contrast, can prescribe controlled substances only if they’ve completed approved training courses. This controlled substances training is set to become a standard part of the curriculum for all NP education programs. However, until that happens, NPs can’t prescribe these substances unless they’ve received specialized training.

A final distinction is that while both family physicians and NPs can provide prenatal care, family physicians can also train in obstetrics if they choose. NPs don’t have this option, so you’ll need to work with either a midwife or an obstetrician/gynecologist (OB/GYN) to deliver your baby if you have an NP for primary care.

What can a nurse practitioner do?

In Canada, nurse practitioners can practice without needing to be supervised by a doctor. This means that like a family doctor, NPs can provide primary care in community health centres (CHCs), family practice teams, and hospitals as well as work in NP-run clinics and other settings.

NPs can take your medical history, perform physical exams, listen to your heart and lungs, and check your blood pressure. They can also diagnose medical conditions, prescribe medications, and provide referrals to specialists. 

On top of that, NPs can order MRI or CT scans as well as other diagnostic tests like X-rays. They’re able to order and interpret lab results as well.

Many additional things are within the scope of practice for NPs including diagnosing and treating sexually transmitted infections (STIs), lancing boils, performing Pap smears and biopsies, prescribing birth control, and inserting or removing IUDs. And, just like a family doctor, NPs can provide prenatal care to you while you’re pregnant. 

Routine vaccinations are often given by NPs, but they can also perform other shots, such as joint injections. For example, if you need a cortisone injection in your knee, an NP can give it to you.

Whether you’re looking to see an NP or a family physician, we can help. Our providers are available day or night, seven days a week, within minutes. For all your diagnosis and treatment or prescription needs, our Canadian-licensed doctors and nurse practitioners are here for you. If you need to see a specialist or get lab work done we can help with that too. No referral needed.

What’s the difference between a registered nurse and a nurse practitioner?

Both registered nurses (RNs) and nurse practitioners are highly trained healthcare professionals. However, how they work with patients differs. RNs work alongside doctors and other healthcare professionals to treat patients and must follow the doctor’s orders when it comes to their patients’ needs. 

In contrast, nurse practitioners can assess and care for patients without being supervised by a physician. Some of the things NPs can do that RNs can’t include:

• Diagnose medical issues and formulate treatment plans
• Order and interpret lab tests
• Order diagnostic imaging
• Prescribe medications
• Refer to a specialist

How do I know which provider is right for me?

Many Canadians are struggling to find a primary healthcare provider right now and are looking for the first one they can access — whether that’s an NP or a family physician.

However, if you have the luxury of choice and are wondering how to know which provider makes the most sense for you, here are some criteria to consider.

1. What’s your health history?
   Patients who have multiple health conditions with conflicting treatments are known as “medically complex.” Because they spend more time in medical school, family physicians typically have more in-depth knowledge when it comes to multiple conflicting medications and diagnoses. If you have more than one chronic condition, you may benefit from seeing a doctor instead of a nurse practitioner. 
2. Do you require controlled medications?
   As mentioned, NPs can only prescribe controlled substances if they have specific training in that area. If you have a condition that requires controlled medication, it’s important to find a provider that can prescribe them, whether that’s a family physician or an NP that’s certified to do so.
3. Do you have a chronic condition?
   If you have a chronic condition like COPD or heart disease, you may think that you can only see a doctor as your primary care provider. The truth is that both family physicians and NPs can care for patients with and without persistent illnesses. If you have a chronic condition, there’s no need to choose a family physician over an NP. Instead, look for a primary care provider that you feel comfortable with.

I don’t have a family doctor, can I see a nurse practitioner instead?

If you don’t have a family physician and you’re looking to see a primary care provider in person, in many cases seeing a nurse practitioner can be a great alternative. This is especially true in telehealth where both NPs and family physicians can address the kinds of concerns that can be treated virtually.

Besides virtual care, NPs practice in a variety of different community and hospital settings. That means you’re likely to see them in community and sexual health centres, long-term care homes, rehabilitation clinics, and hospitals. They can also run their own clinics, work as part of a family health team, and work collaboratively with physicians and other professionals or provide home care.

What’s more, having a nurse practitioner as your primary care provider doesn’t stop you from seeing a doctor too. For example, if you have complex medical needs and your primary care NP feels that the situation is beyond their scope of practice, they can refer you to a doctor like a family physician for care. 

Is my nurse practitioner visit covered by health insurance?

Unlike family physicians, nurse practitioners can’t bill the provincial government for the care they provide. So depending on where you see an NP, there may be a cost involved.

Within clinical settings, NPs are typically paid a salary by their employer. In a publicly-funded clinic — for example, one that operates out of a health centre or a hospital — that means that there’s no cost to the patient for seeing an NP. 

However, within a private setting, you’ll likely have to pay out-of-pocket to see a nurse practitioner. Many clinics also charge additional fees depending on what services the NP performs, such as injections or a Pap test. Some also require a monthly fee just to be able to access that care.

When it comes to telemedicine, visits with NPs or family physicians are only covered in some Canadian provinces currently.

For the millions of Canadians without a family doctor right now, their priority is simply to find a provider that’s accepting new patients — whether that’s an NP, family physician, or general practitioner (GP). However, if you’re medically complex or require controlled prescription medications, you may need to wait a little longer to find the perfect match for you. Depending on where you see your provider, you may also have to consider the financial implications.

For most, however, the bottom line is that both NPs and family physicians are great options for primary care — especially when it comes to telemedicine. That’s why Maple works with the best providers across the country.

We’re committed to changing how Canadians access healthcare. If you need to see a family physician or an NP today, our providers are here for you.